Atıf Sayısı
1
Görüntüleme
11
İndirme
3
Amaç: Çalışmada YBÜ’nde yatan hastalarda gelişen sağlık hizmeti ile ilişkili (SHİ) A. baumannii bakteriyemilerinin klinik özelliklerinin irdelenmesi ve bu enfeksiyon gelişen hastalarda sağkalımı etkileyen risk faktörlerinin saptanması amaçlandı. Yöntem: Yoğun bakım ünitelerinde yatan ve A. baumannii’ye bağlı SHİ bakteriyemi tanısı konulan, erişkin hastalar çalışmaya dahil edildi. Kan kültürlerinde A. baumannii üremesi saptanan ve ilgili hekim/enfeksiyon hekimi tarafından SHİ bakteriyemi tanısı konulan hastalara ait verilere retrospektif olarak hasta dosyaları ve hastane otomasyon sisteminden ulaşıldı. Yaş, cinsiyet, antibiyotik kullanım öyküleri, yatış tanısı, altta yatan hastalıklar, uygulanan invazif girişimler gibi risk faktörleri, SAPS II değerleri ve hastaların mortalite durumları değerlendirildi. Bulgular: Çalışmaya 36 vaka dahil edildi. Vakaların ortalama yaşı (67,3611 (±18) min:20, max:98) ve %55,5 (n:20) erkek idi. En sık ek hastalık hipertansiyon (%22) ve en sık yoğun bakıma yatış tanısı travma (%30) idi. Hastaların yoğun bakıma yatış ortalama SAPS II skoru 54,05+/-16,21 (min:20/max 79) idi. Hastaların demografik özellikleri, uygulanan invaziv işlemler ve antibiyotik tedavileri, mortalite açısından karşılaştırıldığında; yaş, hastanede kalış süresi, SAPS II puanı mortalite gelişen grupta anlamlı olarak yüksek bulundu. Vakalar mortalite gelişen ile mortalite gelişmeyen olarak iki gruba ayrıldı. Mortalite gelişen gruptaki hastaların yaş ortalamasının, ortalama hastanede kalış süresi, SAPS II skoru, SAPS II yüzde değerlerinin daha yüksek olduğu saptandı. Sonuç: Gereksiz antibiyotik tedavisinden kaçınmak ve sıkı enfeksiyon kontrol önlemleri gibi kontrol edilebilir risk faktörlerinin ortadan kaldırılması, A. baumannii kaynaklı bakteriyemileri ve buna bağlı ölümleri azaltabilir. Hastanede uzun süreli kalış, steroid ve antibiyotik maruziyeti varlığı, sınırlı terapötik seçenekleri olan A.baumanii bakteriyemili hastalarda artmış mortalite riskine neden olabilir.
Aim: In this study, it was aimed to examine the clinical features of Acinetobacter baumannii bacteremias associated with health care (SHI) developing in patients in the intensive care unit and to determine the risk factors affecting survival in patients with this infection. Methods: Adult patients hospitalized in intensive care units (ICU) and diagnosed with SHI bacteremia due to A. baumannii were included in the study. The data of patients with A. baumannii growth in at least one set of blood cultures and diagnosed with SHI bacteremia by the relevant physician / infectious physician were retrieved retrospectively from the patient files and the hospital automation system. Risk factors such as age, gender, history of antibiotic use, hospitalization diagnosis, underlying diseases, invasive procedures applied, Simplified Acute Physiology Score (SAPS) II values and mortality status of the patients were evaluated. Results: 6 cases were included in the study. The average age of the cases was (67.3611 (± 18) min: 20, max: 98) and 55.5% (n: 20) male. The most common comorbidities were hypertension (22%) and the most common diagnosis of intensive care admission was trauma (30%). The average SAPS II score of the patients who were hospitalized in intensive care was 54.05 +/- 16.21 (min: 20 / max 79). When demographic characteristics of patients, invasive procedures and antibiotic treatments were compared in terms of mortality; age, SAPS II score was found to be significantly higher in the mortality group. Prolonged hospital stay, the presence of steroid and antibiotic exposure may lead to an increased risk of mortality in A. baumannii bacteremia patients with limited therapeutic options. Avoi- ding unnecessary antibiotic therapy and eliminating controllable risk factors, such as strict infection control measures, can reduce bacteremia and related deaths caused by A. baumannii.
Aim: In this study, it was aimed to examine the clinical features of Acinetobacter baumannii bacteremias associated with health care (SHI) developing in patients in the intensive care unit and to determine the risk factors affecting survival in patients with this infection. Methods: Adult patients hospitalized in intensive care units (ICU) and diagnosed with SHI bacteremia due to A. baumannii were included in the study. The data of patients with A. baumannii growth in at least one set of blood cultures and diagnosed with SHI bacteremia by the relevant physician / infectious physician were retrieved retrospectively from the patient files and the hospital automation system. Risk factors such as age, gender, history of antibiotic use, hospitalization diagnosis, underlying diseases, invasive procedures applied, Simplified Acute Physiology Score (SAPS) II values and mortality status of the patients were evaluated. Results: 6 cases were included in the study. The mean age of the cases was (67.3611 (± 18) min: 20, max: 98) and 55.5% (n: 20) male. The most common comorbidities were hypertension (22%) and the most common diagnosis of intensive care admission was trauma (30%). The mean SAPS II score of the patients who were hospitalized in intensive care was 54.05 +/- 16.21 (min: 20 / max 79). When demographic characteristics of patients, invasive procedures and antibiotic treatments were compared in terms of mortality; age, SAPS II score were found to be significantly higher in the mortality group. Conclusion: Prolonged hospital stay, presence of steroid and antibiotic exposure may lead to an increased risk of mortality in A. baumannii bacteremia patients with limited therapeutic options. Avoi- ding unnecessary antibiotic therapy and eliminating controllable risk factors, such as strict infection control measures, can reduce bacteremia and related deaths caused by A. baumannii.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
Makale Detay 
Atıf Yapanlar
Benzer Makaleler
PDF Görüntüle
Dergi Bilgisi
Eseri Dinleyin
Bu Sayfayı Yazdırın
Paylaş
Mendeley
